Y. Nikitinhttp://repub.eur.nl/ppl/12345/
List of Publicationsenhttp://repub.eur.nl/eur_signature.pnghttp://repub.eur.nl/
RePub, Erasmus University RepositoryRisk factors for Alzheimer's disease in Russia: A case-control studyhttp://repub.eur.nl/pub/62279/
Fri, 01 Sep 2006 00:00:01 GMT<div>A.V. Suhanov</div><div>P.I. Pilipenko</div><div>A.D. Korczyn</div><div>A. Hofman</div><div>M.I. Voevoda</div><div>S.V. Shishkin</div><div>G.I. Simonova</div><div>Y. Nikitin</div><div>V.L. Feigin</div>
No reliable data on risk factors of Alzheimer's disease (AD) are available in Russia. We aimed to evaluate the relative importance of various putative environmental and medical risk factors of AD in a Russian population. We conducted a hospital-based case-control study. Two hundred and sixty consecutive AD patients and an equal number of cognitive impairment-free control subjects matched for sex, age, level of education and place of birth selected from nursing homes and other long-term healthcare facilities in the Novosibirsk region for the period from 1998 to 2002 were examined. A conditional logistic regression analysis was employed to calculate odds ratios (OR) and corresponding 95% confidence intervals (CI) for various putative risk factors. Of the 260 patients with AD, 187 (72%) were females. Patients' age varied from 40 to 89 years (mean ± SD: 69.2 ± 7.7 years). The majority of the patients (77%) had secondary education and 12% had university education. Risk factors independently associated with AD were family history of parkinsonism among first-degree relatives (OR = 4.2; 95% CI 1.2-15.1), hypothyroidism (OR = 2.7; 95% CI 1.1-6.7), and history of head trauma with loss of consciousness (OR = 1.7; 95% CI 1.0-2.8). The most important risk factors for AD in the Russian community are family history of parkinsonism, hypothyroidism and a history of head trauma with loss of consciousness. These findings have implications for developing preventive strategies of AD.Prediction of stroke in the general population in Europe (EUROSTROKE): Is there a role for fibrinogen and electrocardiography?http://repub.eur.nl/pub/22506/
Fri, 01 Feb 2002 00:00:01 GMT<div>K.G.M. Moons</div><div>M.L. Bots</div><div>J.T. Salonen</div><div>P.C. Elwood</div><div>A. Freire de Concalves</div><div>Y. Nikitin</div><div>J. Sivenius</div><div>D. Inzitari</div><div>V. Benetou</div><div>J. Tuomilehto</div><div>P.J. Koudstaal</div><div>D.E. Grobbee</div>
BACKGROUND: To decide whether a person with certain characteristics should be given any kind of intervention to prevent a cardiovascular event, it would be helpful to classify subjects in low, medium and high risk categories. The study evaluated which well known cerebrovascular and cardiovascular correlates, in particular fibrinogen level and ECG characteristics, are able to predict the occurrence of stroke in men of the general population using data from three European cohorts participating in EUROSTROKE.
METHODS: EUROSTROKE is a collaborative project among ongoing European population based cohort studies and designed as a prospective nested case-control study. For each stroke case two controls were sampled. Strokes were classified according to MONICA criteria or reviewed by a panel of four neurologists. Complete data were available of 698 men (219 stroke events) from cohorts in Cardiff (84 cases/200 controls), Kuopio (74/148) and Rotterdam (61/131). Multivariable logistic regression modeling was used to evaluate which information from history, physical examination (for example, blood pressure), blood lipids, and fibrinogen and ECG measurements independently contributed to the prediction of stroke. The area under receiver operating characteristic curve (ROC area) was used to estimate the predictive ability of models.
RESULTS: Independent predictors from medical history and physical examination were age, stroke history, medically treated hypertension, smoking, diabetes mellitus and diastolic blood pressure. The ROC area of this model was 0.69. After validating and transforming this model to an easy applicable rule, 40% of all future stroke cases could be predicted. Adding pulse rate, body mass index, blood lipids, fibrinogen level and ECG parameters did not improve the classification of subjects in low, medium and high risk. Results were similar when fibrinogen was dichotomised at the upper tertile or quintile.
CONCLUSION: In the general male population the future occurrence of stroke may be predicted using easy obtainable information from medical history and physical examination. Measurement of pulse rate, body mass index, blood lipids, fibrinogen level and ECG characteristics do not contribute to the risk stratification of stroke and have no value in the screening for stroke in the general male population.Gamma-glutamyltransferase and risk of stroke: the EUROSTROKE projecthttp://repub.eur.nl/pub/8384/
Tue, 01 Jan 2002 00:00:01 GMT<div>M.L. Bots</div><div>D.E. Grobbee</div><div>J.T. Salonen</div><div>P.C. Elwood</div><div>Y. Nikitin</div><div>A. Freire de Concalves</div><div>D. Inzitari</div><div>J. Sivenius</div><div>A. Trichopoulou</div><div>J. Tuomilehto</div><div>P.J. Koudstaal</div>
BACKGROUND: Alcohol consumption has been implicated in the aetiology of
stroke. As data on alcohol consumption obtained by questionnaire are
susceptible to misclassification, this study evaluated the association
between gamma-glutamyltransferase (gamma-GT), as a marker for alcohol
consumption, and fatal, non-fatal, haemorrhagic and ischaemic stroke in
three European cohort studies, participating in EUROSTROKE. METHODS:
EUROSTROKE is a collaborative project among ongoing European cohort
studies on incidence and risk factors of stroke. EUROSTROKE is designed as
a nested case-control study. For each stroke case, two controls were
sampled. Strokes were classified according to MONICA criteria or reviewed
by a panel of four neurologists. At present, data on stroke and gamma-GT
were available from cohorts in Cardiff (57 cases), Kuopio (66 cases), and
Rotterdam (108 cases). RESULTS: An increase in gamma-GT of one standard
deviation (28.7 IU/ml) was associated with an age and sex adjusted 26%
(95% CI 5 to 53) increase in risk of stroke. Adjustment for confounding
variables such as drug use, history of myocardial infarction, total
cholesterol, and diabetes mellitus did not materially attenuate the
association. The risk of haemorrhagic stroke increased linearly with
increase in gamma-GT. The association for cerebral infarction was not
graded: the risk increased beyond the first quartile, and remained
increased. The association of gamma-GT with stroke was significantly
stronger among subjects without diabetes mellitus compared with subjects
with diabetes mellitus (no association observed). CONCLUSION: This
EUROSTROKE analysis showed that an increased gamma-GT, as a marker of
alcohol consumption, is associated with increased risk of stroke, in
particular haemorrhagic stroke.Total and HDL cholesterol and risk of stroke. EUROSTROKE: a collaborative study among research centres in Europehttp://repub.eur.nl/pub/8386/
Tue, 01 Jan 2002 00:00:01 GMT<div>M.L. Bots</div><div>D.E. Grobbee</div><div>P.C. Elwood</div><div>Y. Nikitin</div><div>J.T. Salonen</div><div>A. Freire de Concalves</div><div>D. Inzitari</div><div>J. Sivenius</div><div>V. Benetou</div><div>J. Tuomilehto</div><div>P.J. Koudstaal</div>
BACKGROUND: Controversy remains on the relation between serum lipids
levels and stroke risk. This paper investigated the association of total
and HDL cholesterol level to fatal and non-fatal, and haemorrhagic and
ischaemic stroke in four European cohorts participating in EUROSTROKE.
METHODS: EUROSTROKE is a collaborative project among ongoing European
cohort studies on incidence and risk factors of stroke. EUROSTROKE is
designed as a nested case-control study. For each stroke case, two
controls were sampled. Strokes were classified according to MONICA
criteria or reviewed by a panel of four neurologists. At present, data on
stroke and risk factors were available from cohorts in Cardiff (84 cases),
Kuopio (74 cases), Rotterdam (157 cases), and Novosibirsk (79 cases).
RESULTS: Pooled analyses showed no significant association between total
cholesterol and risk of stroke (odds ratio for increase of 1 mmol/l in
cholesterol of 0.98 (95% CI 0.88 to 1.09)). Analyses for haemorrhagic
stroke and cerebral infarction revealed odds ratios of 0.80 (95% CI 0.61
to 1.05) and 1.06 (95% CI 0.94 to 1.19), respectively. The association of
HDL cholesterol to stroke was different in men compared with women. In
men, there was a general trend towards a lower risk of stroke with an
increase in HDL (odds ratio per 1 mmol/l increase in HDL cholesterol 0.68
(95% CI 0.40 to 1.16)). In women, however, an increase in HDL was
associated with a significant increased risk of non-fatal stroke and of
cerebral infarction (odds ratios of 2.46 (95% 0.1.20 to 5.04) and 2.52
(95% CI 1.15 to 5.50), respectively. The difference between men and women
in the association of HDL with stroke seemed to differ mainly in smokers
and never smokers, but not among ex smokers. CONCLUSION: This analysis of
the EUROSTROKE project could not disclose an association of total
cholesterol with fatal, non-fatal, haemorrhagic or ischaemic stroke. HDL
cholesterol however, seemed to be related to stroke differently in men
than in women.Level of fibrinogen and risk of fatal and non-fatal stroke. EUROSTROKE: a collaborative study among research centres in Europehttp://repub.eur.nl/pub/8391/
Tue, 01 Jan 2002 00:00:01 GMT<div>M.L. Bots</div><div>D.E. Grobbee</div><div>P.C. Elwood</div><div>J.T. Salonen</div><div>A. Freire de Concalves</div><div>J. Sivenius</div><div>A. di Carlo</div><div>Y. Nikitin</div><div>V. Benetou</div><div>J. Tuomilehto</div><div>P.J. Koudstaal</div>
BACKGROUND: It is well established that raised levels of fibrinogen
increase the risk of coronary heart disease. For stroke, however, data are
much more limited and restricted to overall stroke. This study
investigated the association between fibrinogen and fatal, non-fatal,
haemorrhagic and ischaemic stroke in three European cohorts participating
in EUROSTROKE. METHODS: EUROSTROKE is a collaborative project among
ongoing European cohort studies on incidence and risk factors of stroke.
EUROSTROKE is designed as a nested case-control study. For each stroke
case, two controls were sampled. Strokes were classified according to
MONICA criteria or reviewed by a panel of four neurologists. Recently,
data on stroke and fibrinogen became available from cohorts in Cardiff (79
cases/194 controls), Kuopio (74/124), and Rotterdam (62/203). Results were
adjusted for age, sex, smoking, and systolic blood pressure. RESULTS: The
risk of stroke gradually increased with increasing fibrinogen levels: the
odds ratios per quartile increase were 1.08 (95% CI 0.63 to 1.84), 1.91
(1.12 to 3.26) and 2.78 (1.64 to 4.72), respectively. This association was
similar for ischaemic (n=138) and haemorrhagic stroke (n=25). Associations
between fibrinogen and stroke were similar across strata of smoking,
diabetes mellitus, previous myocardial infarction, and HDL cholesterol.
The odds ratio, however, tended to increase with increasing systolic blood
pressure: from 1.21 among those with a systolic pressure <120 mm Hg to
1.99 among subjects with a systolic pressure of 160 mm Hg or above.
CONCLUSION: This analysis of the EUROSTROKE project indicates that
fibrinogen is a powerful predictor of stroke. Results did not disclose a
differential in this relation of fibrinogen and fatal or non-fatal stroke,
or with type of stroke (ischaemic or haemorrhagic).Left ventricular hypertrophy and risk of fatal and non-fatal stroke EUROSTROKE: a collaborative study among research centres in Europehttp://repub.eur.nl/pub/8395/
Tue, 01 Jan 2002 00:00:01 GMT<div>M.L. Bots</div><div>J. Tuomilehto</div><div>D.E. Grobbee</div><div>P.J. Koudstaal</div><div>Y. Nikitin</div><div>J.T. Salonen</div><div>P.C. Elwood</div><div>S. Malyutina</div><div>A. Freire de Concalves</div><div>J. Sivenius</div><div>A. di Carlo</div><div>P. Lagiou</div>
BACKGROUND: This study investigated the association between
electrocardiographically assessed left ventricular hypertrophy (LVH) and
fatal, non-fatal, haemorrhagic and ischaemic stroke in four European
cohorts participating in EUROSTROKE. METHODS: EUROSTROKE is a
collaborative project among ongoing European cohort studies to investigate
differences in incidence of, and risk factors for, stroke between
countries. EUROSTROKE is designed as a nested case-control study. For each
stroke case, two controls were sampled. Strokes were classified according
to MONICA criteria or reviewed by a panel of four neurologists. LVH was
assessed according to the Minnesota code or the automated diagnostic MEANS
classification system. For this analysis, data on LVH and stroke were
available from cohorts in Cardiff (84 cases/200 controls), Kuopio
(60/116), Rotterdam (114/334), and Novosibirsk (62/168). Results are
adjusted for age and sex. RESULTS: LVH was associated with a twofold
increased risk of stroke (odds ratio 2.1 (95% CI 1.3 to 3.5). The risk was
particularly pronounced for fatal stroke (4.0 (95% CI 2.1 to 7.9)),
whereas the risk was non-significantly increased for non-fatal stroke (1.5
(95% CI 0.8 to 2.7)). The increased risk was more pronounced in smokers:
for total stroke 3.5 (95% CI 1.5 to 8.1) versus 1.6 (95% CI 0.8 to 3.1) in
non-smokers. Adjustment for systolic blood pressure and body mass index
attenuated the associations. LVH was not preferentially associated with a
particular type of stroke, although the association with cerebral
infarction was stronger. CONCLUSION: This analysis of the EUROSTROKE
project indicates that LVH assessed by electrocardiogram is a predictor of
stroke. The association seems to be stronger for fatal stroke than for
non-fatal stroke and is more pronounced in smokers.The EUROSTROKE cohorts: a short description and data analytical approachhttp://repub.eur.nl/pub/8396/
Tue, 01 Jan 2002 00:00:01 GMT<div>M.L. Bots</div><div>D.E. Grobbee</div><div>P.C. Elwood</div><div>Y. Nikitin</div><div>J.T. Salonen</div><div>A. Freire de Concalves</div><div>D. Inzitari</div><div>J. Sivenius</div><div>A. Trichopoulou</div><div>J. Tuomilehto</div><div>P.J. Koudstaal</div>
This paper describes the design and methodology of the participating
cohorts in the EUROSTROKE project. Information is given about the cohort
sampling, its size, the follow up procedures and event classification.
Information is also given about the measurement of the cardiovascular and
cerebrovascular risk factors in each of the cohorts separately. The
cohorts described are the Caerphilly study in Cardiff, United Kingdom; the
Kuopio Ischaemic Heart disease study in Kuopio, Finland; the Portugal
study in Coimbra, Portugal; the EPIC cohort in Athens, Greece; the Ilsa
study from Firenze, Italy; the Rotterdam Study in Rotterdam, the
Netherlands, and the Novosibirsk cohort in Novosibirsk, Russia.